Tests for detecting renovascular hypertension

Renovascular hypertension is the most common potentially curable form of arterial hypertension. It occurs as a result of insufficient perfusion of renal tissue, secondary to haemodynamically significant stenosis of the renal artery or its branches. Early diagnosis is of primary importance in patients with renovascular hyper­tension, as timely treatment by percutaneous transluminal renal angioplasty or surgical revas­cularization may afford definitive cure or at least improvement of renovascular hypertension, and thus prevent further deterioration of renal func­tion. A number of tests for detection of renovas­cular hypertension are available, yet their accu­racy rate is fairly low. An ideal screening test for renovascular hypertension should not only iden­tify the presence and location of renal artery stenosis, but should also determine its haemodynamical significance. Finally, the paper pre­sents the pathogenesis of renovascular hyper­tension, and describes the available screening tests and the algorithm used in patients with sus­pected renovascular hypertension.